Clinical Studies
Welcome to our Clinical Studies page. At MolnuFIP™, we are dedicated to providing evidence-based treatments for feline infectious peritonitis (FIP). This page highlights the extensive clinical research and studies that support the efficacy and safety of our MolnuFIP™ EIDD-1931 treatment.
Our commitment to scientific research ensures that each product is backed by solid data and thorough testing. Here, you can explore detailed reports, study results, and expert analyses demonstrating the high success rates and low relapse rates of EIDD-1931. We believe in transparency and the importance of sharing this critical information with our customers and veterinary partners.
Stay informed and confident in your choice of MolnuFIP™ as a trusted solution for FIP treatment.
Alternative treatments for cats with FIP and natural or acquired resistance to GS-441524
Read the full Study:
https://www.fipwarriors.eu/en/alternativna-liecba-maciek-s-fip-a-prirodzenou-alebo-ziskanou-rezistenciou-na-gs-441524/
The situation with EIDD-1931 and EIDD-2801/Molnupiravir and GS-441524 and Remdesivir brings to question why some drugs are converted to prodrugs for marketing [17]. Remdesivir was reportedly esterified to increase antiviral activity, although studies in cats showed that GS-441524 and Remdesivir had similar virus inhibitory activity in tissue culture [18]. However, Remdesivir was found to be poorly absorbed by the oral route and was therefore conditionally approved only for injection. EIDD-2801 was created to enhance oral absorption of EIDD-1931, even though earlier research indicated that EIDD-1931is well absorbed orally without esterification [6]. The motives behind the commercialization of Remdesivir instead of GS-441524 for use in humans has been scientifically questioned, as the latter appears to be superior in several ways without further modifications [17]. Why was EIDD-2801 was put forward for commercialization when EIDD-1931 would be cheaper, 4 times more virus inhibitory and one third less toxic than EIDD-2801 [15]? Strength of...
The long history of Beta-d-N4-hydroxycytidine and its modern application to treatment of Covid-19 in people and FIP in cats.
Read the full Study:
https://ccah.vetmed.ucdavis.edu/sites/g/files/dgvnsk4586/files/inline-files/Molnuparivir%20as%20a%20third%20antiviral%20drug%20for%20treatment%20of%20FIP%20v13_1.pdf
Resistance to GS-441524 has been confirmed in a number of cats that have been treated for FIP with GS-441524 in the last 3 years, especially among cats with neurological FIP [5]. Resistance to GS441524 is usually partial and higher doses often cure the infection or significantly reduce the symptoms of the disease during treatment. Interestingly, resistance to GS-441524 has also been found in patients with Covid19 treated with Remdesivir [12]. An immunocompromised patient developed a prolonged course of SARS-CoV-2 infection. Remdesivirus treatment initially alleviated symptoms and significantly reduced virus levels, but the disease returned with a large increase in virus replication. Whole genome sequencing identified an E802D mutation in nsp12 RNA-dependent RNA polymerase that was not present in pre-treatment samples and caused a 6-fold increase in resistance.
Although the history of molnupiravir and its recent use in the treatment of FIP has been described [6], there are currently no studies documenting natural or acquired resistance to molnupiravir. Molnupiravir has been shown to function as an RNA mutagen causing several defects in the viral genome [7]while remdesivir / GS-441524 is a non-binding RNA chain terminator [8], which suggests that its resistance profile will be different.
Feline Infectious Peritonitis: European Advisory Board on Cat Diseases Guidelines
Read the full Study:
https://pmc.ncbi.nlm.nih.gov/articles/PMC10535984/
The molnupiravir was given either as first-line treatment in 4 cats or as rescue treatment in 26 cats that had received an initial treatment for suspected FIP with unlicensed GS-441524, or a drug combination including unlicensed GS-441524, as the main drug. Thirteen of the cats were treated with injectable GS-441524 only, three cats were treated with oral GS-441524 only, and an additional seven were treated with a combination of injectable and oral GS-441524 throughout the duration of therapy. Two were treated with a combination of unlicensed GS-441524 and unlicensed protease inhibitor antiviral GC376 (see Section 10.1.4 on GC376, a protease inhibitor), whilst one cat was treated with
Efficacy against Feline Infectious Peritonitis Virus with Pharmacokinetic Analyses of GS-441524, Remdesivir, and Molnupiravir in Cats
Read the full Study:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9697187/
SUMMARY
Feline infectious peritonitis (FIP) is a fatal disease of cats that currently lacks licensed and affordable vaccines or antiviral therapeutics. The disease has a spectrum of clinical presentations including an effusive (“wet”) form and non-effusive (“dry”) form, both of which may be complicated by neurologic or ocular involvement. The feline coronavirus (FCoV) biotype, termed feline infectious peritonitis virus (FIPV), is the etiologic agent of FIP. The objective of this study was to determine and compare the in vitro antiviral efficacies of the viral protease inhibitors GC376 and nirmatrelvir and the nucleoside analogs remdesivir (RDV), GS-441524, molnupiravir (MPV; EIDD-2801), and β-D-N4-hydroxycytidine (NHC; EIDD-1931). These antiviral agents were functionally evaluated using an optimized in vitro bioassay system. Antivirals were assessed as monotherapies against FIPV serotypes I and II and as combined anticoronaviral therapies (CACT) against FIPV serotype II, which provided evidence for synergy for selected combinations. We also determined the pharmacokinetic properties of MPV, GS-441524, and RDV after oral administration to cats in vivo as well as after intravenous administration of RDV. We established that orally administered MPV at 10 mg/kg, GS-441524 and RDV at 25 mg/kg, and intravenously administered RDV at 7 mg/kg achieves plasma levels greater than the established corresponding EC50 values, which are sustained over 24 h for GS-441514 and RDV.
Unlicensed Molnupiravir is an Effective Rescue Treatment Following Failure of Unlicensed GS-441524-like Therapy for Cats with Suspected Feline Infectious Peritonitis
Read the full Study:
In total, 26 out of 30 cats received an initial treatment for suspect FIP with unlicensed GS-441524 or a drug combination including unlicensed GS-441524 as the main base drug (GS-441524-based). Half (13) of the cats were treated with injectable GS-441524. Only three cats were treated with oral GS-441524, with an additional seven treated with a combination of injectable and oral GS-441524 throughout the duration of therapy. Two were treated with a combination of unlicensed GS-441524 and unlicensed GC376. Cat #6 was treated with all the previously mentioned drugs along with molnupiravir for 12 weeks of a highly complicated regimen (Supplemental Data S2).
EIDD-2801 (MOLNUPIRAVIR)
Read the full Study:https://www.fipwarriors.eu/en/eidd-2801-molnupiravir/
As already mentioned, EIDD-2801 is the precursor of EIDD-1931. Thus, the relationship of EIDD-2801 to EIDD-1931 is equivalent to that of Remdesivir and GS-441524. Since the molecular weight of EIDD-2801 is 329.31 g-mol and EIDD-1931 is 259.22 g/mol, it can be assumed that the dosage ratio of EIDD-2801 and EIDD-1931 is governed by a ratio of 1.27. In other words, if we use EIDD-1931 in a dosage of 10mg/kg, we should use about 12.7mg/kg for EIDD-2801.
It should be noted at this point that EIDD-1931 is not commercially distributed and you will most likely encounter EIDD-2801. However, the existence of EIDD-1931 should be kept in mind in case you come across this medicine.
Eighteen cats diagnosed with FIP at the You-Me Animal Clinic, Sakura-shi, Japan between January and August 2022, and whose owners gave informed consent to this experimental treatment.
For this prospective observational study, molnupiravir tablets were compounded in-house at the You-Me Animal Clinic. Owners administered 10-20 mg/kg PO twice daily. Standard treatment duration was 84 days.
Results: Among 18 cats, 13 cats had effusive FIP and 5 had noneffusive FIP. Three cats had neurological or ocular signs of FIP before treatment. Four cats, all with effusive FIP, died or were euthanized within 7 days of starting treatment. The remaining 14 cats completed treatment and remained in remission at the time of writing (139-206 days after starting treatment). Elevated serum alanine transaminase (ALT) activity was found in 3 cats, all at Days 7-9, and all recovered without management. Two cats with jaundice were hospitalized, 1 during treatment (Day 37) and 1 with severe anemia at the start of treatment.
This case series suggests that molnupiravir might be an effective and safe treatment for domestic cats with FIP at a dose of 10-20 mg/kg twice daily.